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Wisconsin Office of Rural Health

Top Flex Activities

Program Area: Support for Quality Improvement

The Wisconsin Office of Rural Health (WI-ORH) uses Medicare Beneficiary Quality Improvement Project (MBQIP) data to identify hospitals with low Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Five critical access hospitals (CAHs) will be offered the opportunity to work with a contractor who will provide on-site measure improvement. The contractor will provide recommendations on how each hospital can improve customer service and HCAHPS scores in each hospital, including:

Assessment of current customer service practices and policies

Identification of areas of strengths and areas of needed improvement

Development of a work plan to assist each hospital as they improve customer service and HCAHPS scores

Please share a success story about reporting quality data or using quality data to help CAHs in your state improve patient care.

In order to select CAHs for participation in the Wisconsin Flex Program's Population Health Improvement Project, Flex staff reviewed each CAH’s community health needs assessment (CHNA) and identified all CAHs that listed obesity as one of their top three issues to address. Next, the 15 counties with the highest obesity rates were identified using County Health Rankings. CAHs that were in one of these 15 counties and also identified obesity reduction as a top issue in their CHNA were offered the opportunity to submit a proposal, detailing an initiative aimed at reducing obesity within their community. Three hospitals were selected, and have completed their planning year. These hospitals are now in the implementation phase of their projects.

Program Area: Support for Financial and Operational Improvement

The Wisconsin Flex Program identified CAHs that were at the highest level of financial risk in the state. A request for proposals was issued to the identified CAHs, asking them to submit their identified need with a proposed project to address that need and anticipated outcomes. The Wisconsin Flex Program has provided funding for seven CAHs and their proposed financial improvement projects. All CAHs have reporting requirements that are submitted to the Wisconsin office. It is likely that change will not be seen immediately after the completion of the proposed project, so follow up will occur not only at the end of the grant period, but also at several points in the future to ascertain if improvements have been made and projected goals achieved.

Program Area: Support for Population Health Management and Emergency Medical Services Integration

WI-ORH developed an Emergency Medical Services (EMS) Patient Care Assessment that focused on stroke, ST-elevated myocardial infarction (STEMI), trauma and cardiac arrest patient care policies and practices. Each survey respondent was asked whether their service has time critical diagnosis (TCD) protocols and quality assurance policies, as well as whether they work with receiving hospitals on quality assurance. The response rate was over 70%. WI-ORH enlisted the services of a contractor to provide one-on-one technical assistance to several EMS services that rated themselves low on the assessment. The contractor has worked with three services thus far to identify areas for improvement, including the development and implementation of an improvement plan for each EMS service. The contractor will go on to work with six more agencies in the current fiscal year.

Please provide information about any efforts to assist CAHs/communities and partner organizations in the transition to value-based care.

Wisconsin is fortunate to have many strong rural partners, such as the Wisconsin Hospital Association and the Rural Wisconsin Health Cooperative. These organizations have expertise in the move to value-based care and provide support, education and resources to rural hospitals in Wisconsin. The Wisconsin Flex Program works with these partners to incorporate activities into the Flex proposal that help support hospitals in the transition. CAHs can seek support and technical assistance from both the Flex office and a number of Wisconsin organizations.

Please provide information about network activities in your state to support Flex Program activities.

Wisconsin takes part in the following networks: Wisconsin Rural Health Council (led by the Wisconsin Hospital Association), Wisconsin Stroke Coalition, Wisconsin STEMI Coalition, Wisconsin Coordination of Care Advisory Committee, the Wisconsin Healthcare Coalition Advisory Group and the Wisconsin Rural Health Development Council.

Please describe how your state Flex Program has enhanced its use of data in the past year.

WI-ORH has created the Wisconsin EMS Agencies Interactive Map using data from the Wisconsin Department of Health Services, EMS Office. The interactive map displays the location of agencies that provide emergency medical services to communities throughout Wisconsin. The map includes filters that allow users to view agencies by rurality, license level, service type, county and Regional Trauma Advisory Council (RTAC) region.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,100,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Upcoming Events

The tentative topic for the March Flex VKG is CAHMPAS. Flex VKG webinars provide a forum for state Flex Programs to share successes, discuss challenges and brainstorm strategies for improvement and Flex Program excellence.

The tentative topic of the May TASC 90 is an update on the Flex supplemental funding EMS projects. This quarterly webinar will include updates from TASC, RQITA, FMT and FORHP, to include both the Flex Program and policies impacting critical access hospitals (CAHs).